HomeMy WebLinkAbout0098 CONNERS ROAD - Health (2) w .
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Town of Barnstable P# 51 / 9
Department of Health,Safety,and Environmental Services
IN Public Health Division Date 5`-
Q„ 367 Main Street,Hyannis MA 02601
RAIUMABM
.a Date Scheduled b s - d Time
Ec t mew► Fee Pd. 100
Soil Suitability Assessment for Sewage Disposal
Performed.By: i—I�>a�4 Li Witnessed By: ��r_-
..:. . . . ; Lt) ATION&GENERAL INFORMATION
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Location Address 'p� Owner's Name
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b V VD& Address
Assessor's Map/Parcel: Z5_1L Engineer's Name .Toy ' �svL
NEW CONSTRUCTION REPAIR V Telephone#
Land Use X�s 14�� , Slopes(%) htVJ:—_ Surface Stones 1V p
Distances from: Open Water Body Z3D ft Possible Wet Area ft Drinking Water Well ft
"Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
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Parent material(geologic)"13 Depth to Bedrock�A.
Depth to Groundwater: Standing Water in Hole: o lL Weeping from Pit Face o
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Estimated Seasonal High Groundwater < t.—z-L 3S 'l�Lf(_...
Y3 'E NA, .ION*FOR'SEAS;ONA MGM AT)�Yt' `ABT.
Method Used. l _
Depth Obse ed standing hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
.Index Well# •Reading Date: Index Well level .__ Adj.factor Adj.Groundwater Level_
PER+COLA`Tttl► i TEST: _Hate �° T�m�fr
Observation
Hole# Z Time at 9"
Depth of Perc 3(o !•O Time at 6"
Start Pre-soak Time @ Time(9"-6")
End Pre-soak 1 Z= Zl(� i ��A��11=_ �" �j9 1—'�_. r
Rate Min./Inch L 2 L Z
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant
DEEP bBSERVATION H I E L0G Hole€#
.
Depth from Soil Horizon Soil Texture Soil Color Soil ther
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistencv.°o Gravel)
zA-l3 T71Z4 z.> / � 1
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DEEP 08SERATION HALE LQG Hale#: .: .
.....:.-.
Depth from Soil Horizon Soil Texture Soil Color Soil er
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Con i t nc %Gravel)
`j lad b
p— A goy Q.3 f l..ouSj— sTo,1i
Z -157 L S, lb Ct.5 �' tLw- 1Z
DEEP BSERVATI HOLE LHG„ Hble#.
................................................................... ..................................................................
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,%Gravel)
DEEI*OBSERVATION HIE3TE LClaG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Con is en %Gravel)
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No_ Yes
Within 100 year flood boundary No_ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervi us material exist in all areas observed throughout the
area proposed for the soil absorption system? l
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environ ental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature Date -ZS